MR-Brachytherapy Suite offers outpatient procedure

TORONTO – For one of the first times in the world, a patient at Sunnybrook in August received gynecological interstitial brachytherapy as an outpatient procedure, thanks to the hospital’s MR-Brachytherapy Suite.

Brachytherapy strikes tumours with high doses of radiation and is used in the treatment of prostate, breast and gynecological cancers. For interstitial brachytherapy for gynecological cancers, a cylinder and applicators that look like needles are inserted into the tumour, around the vagina, cervix or uterus.

The applicators are attached to a treatment unit that moves a radiation source precisely through the applicators to destroy the tumour while avoiding harm to the patient’s normal tissues

Currently, for most gynecological interstitial brachytherapy, an MR image is taken about a week before the procedure. The radiation oncology team uses the MRI to plan the placement of the needles in relation to the cylinder that is placed into the vagina. The full procedure could take up to 48 hours, with an overnight stay.

Sunnybrook’s MR-Brachytherapy Suite, which is made up of an operating room, radiation bunker and MRI machine for imaging, allows for a much more streamlined approach.

“Having the suite allows us to image MR in real time for optimal applicator placement, planning and even treatment. The patient doesn’t have to be awake with the applicator in place and instead can have the treatment all done while under anesthesia,” Dr. Eric Leung, radiation oncologist, explained.

Prior to the suite, patients would have to wait for a few hours – awake – with the applicator inserted, which many found to be uncomfortable or painful. They were also awake for the applicator removal.

Sunnybrook is also testing electromagnet technology that helps guide the needle placement for increased precision during the procedure.

“Our brachytherapy team is excited by this leap forward in the evolution of our program,” said Ananth Ravi (pictured), PhD. “The efforts of our team, the introduction of innovative technologies and our MR-Brachytherapy Suite working in concert enable us to deliver not just effective, but truly compassionate, patient-centred care.”

Sunnybrook is working to adopt this workflow as a standard of care for gynecological interstitial brachytherapy patients moving forward.